《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (12): 1190-1191.

• 论文 • 上一篇    下一篇

手足口病并发急性弛缓性麻痹30例临床分析

刘静1a，罗如平1a，胡南1b，王军英1c，刘湘梅1a   

  1. 1.湖南省儿童医院，a.感染科；b.特检科；c.理疗科，湖南长沙市 410007。
  • 收稿日期:2010-09-19 修回日期:2010-11-15 出版日期:2010-12-25 发布日期:2010-12-25

30 Children with Hand Foot and Mouth Disease following Acute Flaccid Paralysis

LIU Jing, LUO Ru-ping, HU Nan, et al   

  1. Department of Infection, Hunan Province Children's Hospital, Changsha 410007, Hunan, China
  • Received:2010-09-19 Revised:2010-11-15 Published:2010-12-25 Online:2010-12-25

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被引次数

22

摘要： 目的探讨手足口病(HFMD)并发急性弛缓性麻痹(AFP)的流行特征及临床表现。方法回顾性分析30例手足口病并发AFP患儿的临床及流行病学资料。结果30例患儿以农村多见(90.00%)，年龄均在5岁以下，1～3岁多见，占83.34%。除肢体急性迟缓性麻痹外，多数并发脑炎(86.67%)，以发热(100.00%)、皮疹(100.00%)、惊跳(80.00%)、呕吐(63.33%)为主要表现，部分并发神经源性肺水肿(13.33%)和尿潴留(16.67%)。瘫痪多数出现在病程第3～5天，以下肢瘫痪为主，少数为上肢瘫痪或四肢瘫。检出肠道病毒71型(EV71)26例，其他肠道病毒1例，阴性3例。肌电图提示股神经、胫神经、腓神经、腋神经或肌皮神经运动传导动作电位波幅降低为主，或/和运动传导速度减慢，近端神经受累多见。结论手足口病并发AFP主要由EV71感染所致，并发脑炎多见；流行期间临床症状较散发肠道病毒感染所致AFP重，预后良好。

关键词: 手足口病, 急性弛缓性麻痹, 临床表现

Abstract: ObjectiveTo investigate the clinical characteristics and epidemic analysis in children with hand foot and mouth disease(HFMD) following acute flaccid paralysis(AFP).Methods30 children with HFMD following AFP in Hunan Province Children's Hospital were surveyed retrospectively.ResultsAll the patients were below 5 years old, 83.34％ were 1～3 years old, 90% from countryside. Besides AFP of limbs, 86.67% complicated with encephalitis. The major clinical characteristics as followed: fever(100.00%), skin rash(100.00%), startle and skip(80.00%), emesis(63.33%), neurogenic pulmonary edema(13.33%) and urinary retention(16.67%). The most palsy occurred in 3～5 days after onset, and the palsy in lower limbs was major, only a few had palsy in upper extremities or tetraplegia. 26 cases were infected with enterovirus type 71(EV 71), 1 case infected other EV, 3 cases were negatively. The EMG showed that the amplitude of active potential lowered in the femoral nervus, tibial nerve, peroneal nerve, axillay nerve and musculocutaneous nerve, or/and the motor conduction velocity slowed down, the damage of proximate nerve was the most common.ConclusionThe most children with HFMD following AFP were infected with EV 71. Encephalitis was the common complication. The symptom of EV 71 was more severious than distribute EV.

Key words: hand foot and mouth disease, acute flaccid paralysis, clinical manifestation